Rural Allied Health Scholarships: do they make a difference?

INTRODUCTION The problem of recruiting and retaining a qualified rural and remote health workforce is well recognised and a number of strategies have been put in place to address this issue, including the use of bonded scholarship programs. However there is a paucity of evidence regarding the impact of scholarships on workforce outcomes particularly in relation to allied health professionals. This project involved a review of the Queensland Health Rural Scholarship Scheme (Allied Health) (QHRSS-AH) including impacts on those engaged with the scholarship program and for the funding organisation. Specifically this study aimed to examine the profile of the QHRSS-AH recipients from 2000 to 2010 including graduate recruitment outcomes and retention within the scholarship program. It also explored the influence of the QHRSS-AH on early career practice location decisions and the features of the scheme that influenced motivation to be involved as either a scholarship holder or manager, perceived barriers to employment of scholarship holders in rural or remote services, experiences of scholarship holders as new graduates in rural and remote services and views on support requirements. METHODS A mixed methods study was conducted involving quantitative analysis of existing Queensland Health scholarship data and a qualitative study that used one-on-one, in-depth telephone interviews with 17 past or current scholarship holders and 11 managers of scholarship holders. RESULTS Of the 146 participants, 69.2% had completed or were completing the service period (41.1% were post-bond and 28.1% were currently completing the service period). Of the remainder, 14.4% were still completing the study period, 2.7% had deferred the service period and 13.7% had broken service bonds. Scholarship holders and managers indicated support for scholarships. Key motivators for applying for a scholarship were financial and job security upon graduation, although the general appeal of and preference for rural practice was an underlying motivator. Regardless of receiving a scholarship, most scholarship recipients reported they would have gone into rural and remote practice. Professional and clinical support and supervision, supportive work environment and culture, mentoring and professional development are important for retention. New graduates need extra support to assist in the undergraduate-to-practice transition and both scholarship holders and managers emphasised the important role played by health services in having well defined, consistent, operational processes that orient and support new graduates particularly in relation to supervision, mentoring and professional development. CONCLUSION Although scholarship holders and their managers support the rural scholarship program, aspects of the scholarships in their current form require consideration in light of current workforce supply and demand and changing professional structures within the organisation. While many scholarship holders felt well supported as a new graduate entering rural practice, others identified gaps in relation to their experiences and the support they received. Opportunities exist for more standardised approaches across all services to strengthen the support structures that are in place, particularly for new graduates.